• Title/Summary/Keyword: medical direction methods

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A Qualitative Study on Traditional Korean Medicine Treatment for Child Patients with Night Crying - With a Focus on Descriptions by Main Fosterers - (야제 환아의 한의치료에 대한 질적 연구 - 주양육자의 서술을 중심으로 -)

  • Kim, Hyejin;Jeon, Chaeheun;Kim, Eunji;Kim, Hyunho;Leem, Jungtae;Ryu, Suhyang
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.1
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    • pp.44-53
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    • 2018
  • Objectives This study sets out to examine treatment experiences of child patients with night crying based on the traditional Korean medicine. Also, the study traces the process in which clients chose traditional Korean medicine treatment, and proposes a possible future direction of Korean medicine treatment. Methods The investigator conducted a semi-standardized open-ended question interview with two main fosterers of a child who received traditional Korean medicine treatment for night crying, and examined two fosterers' experiences of a child with the traditional Korean medicine treatment. Their interviews were recorded with their facial expressions and acts for analysis. Collected data was analyzed based on the Grounded theory. Results The participants felt a sense of responsibility, worry, and fear for their children with night crying. They had easy access to traditional Korean medicine doctors who were in the community and had positive experiences with traditional Korean medicine treatment. They reported that some people had been forced to use traditional Korean medicine, had misunderstandings about traditional Korean medicine, and had prejudice that night crying is not a disease. They felt there was a room for improvement in terms of the high medical expenses and the absence of a cooperative system between Oriental and Western medicine. Conclusions As the first qualitative study on night crying based on the traditional Korean medicine treatment, this study proposed a future direction for traditional Korean medicine treatment for night crying in the shoes of fosterers. The findings showed that the fosterers chose traditional Korean medicine treatment for night crying child based on their feelings, accessibility and experiences with traditional Korean medicine. Fosterers felt a need for improvement of the general public's perceptions about Korean medicine treatment on night crying, and a cooperative system between Oriental and Western medicine.

Detection of Gastric Contraction in Electrogastrography: Spectrum Analysis and Vector Analysis (위전도에서의 위수축 측정방법 : 주파수영역분석 및 벡터분석)

  • Kim, In-Young;Han, Wan-Taek
    • Journal of Biomedical Engineering Research
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    • v.18 no.3
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    • pp.273-283
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    • 1997
  • Electrogastrography(EGG), the cutaneous recording of the myoelectrical activity of the stomach using surface electrodes, is attactive due to its non-invasiveness. Despite many attempts made over the decades, analysis of surface EGG has not led to identification of contraction-related electrical response activity of the stomach that would help the clinician to diagnose motility disorders of the stomach. We propose feasible methods to detect the gastric contraction by spectrum analysis and vector analysis of the surface EGG signal. A running spectral analysis(RSA) based on the fast Fourier transform (FFT) was applied to the filtered EGG signal. The powers of dominant frequency and its harmonics were compared with gastric contraction signals such as the strain gauge signal from the gastric serosa in dog or the antropyloric pressure in human. And we also carried out vector analysis of the filtered EGG signals obtained from three paired electrodes. The amplitude and direction of the calculated EGG vector were analyzed and compared with the gastric contraction signals. From the spectrum analysis, we found that the increase of the power of the first harmonic of the dominant frequency was highly correlated with the gastric contraction. And from the vector analysis of the EGG signal, we found a typical change of the amplitude and direction of the EGG vector, which can indicate occurrences of the gastric contraction.

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Microsurgical DREZotomy for Deafferentation Pain (구심로 차단 동통에서의 미세 후근 진입부 절제술)

  • Kim, Seong-Rim;Lee, Kyung Jin;Cho, Jeong Gi;Rha, Hyung Kyun;Park, Hae Kwan;Kang, Joon Ki;Choi, Chang Rak
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup1
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    • pp.85-90
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    • 2001
  • Objective : DREZotomy is effective for the treatment of deafferentation pain as a consequence of root avulsion, postparaplegic pain, posttraumatic syrinx, postherpetic neuralgia, spinal cord injury, and peripheral nerve injury. We performed microsurgical DREZotomy to the patients with deafferentation pain and relieved pain without any serious complication. The purpose of this study is to evaluate the usefulness of the microsurgical DREZotomy for deafferentation pain. Methods : We evaluated 4 patients with deafferntation pain who were intractable to medical therapy. Two of them were brachial plexus injury with root avulsion owing to trauma, one was axillary metastasis of the squamous cell carcinoma of the left forearm, and the last was anesthesia dolorosa after surgical treatment(MVD and rhizotomy) of trigeminal neuralgia. Preoperative evaluation was based on the neurologic examination, radiologic imaging, and electrophysiological study. In the case of anesthesia dolorosa, we produced two parallel lesions in cephalocaudal direction, 2mm in distance, from the C2 dorsal rootlet to the 5mm superior to the obex including nucleus caudalis, after suboccipital craniectomy and C1-2 laminectomy, with use of microelectrode. In the others, we confirmed lesion site with identification of the nerve root after hemilaminectomy. We performed arachnoid dissection along the posterolateral sulcus and made lesion with microsurgical knife and microelectrocoagulation, 2mm in depth, 2mm in distance, to the direction of 30-45 degrees in the medial portion of the Lissauer's tract and the most dorsal layers of the posterior horn at the one root level above and below the lesion. Results : Compared with preoperative state, microsurgical DREZotomy significantly diminished dosage of the drugs and relieved pain meaningfully. One patient showed tansient ipsilateral ataxia, but recovered soon. There was not any serious complication. Conclusion : It may be concluded that microsurgical DREZotomy is very useful and safe therapeutic modality for deafferentation pain, especially segmentally distributed intermittent or evoke pain. Complete preoperative evaluation and proper selection of the patients and lesion making device are needed to improve the result.

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Structuralistic Analysis for Establishment of Concept and Variables of Shanghan Diseases (상한병(傷寒病)의 개념(槪念)과 논치근거(論治根據) 확립을 위한 구조주의적 분석)

  • Chi, Gyoo Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.29 no.2
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    • pp.127-132
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    • 2015
  • In order to grasp the clear concepts and variables to treat Shanghan diseases which has complex meaning by each medical literature, several concepts and analytic method of structuralism from early to late stage encompassing Saussure and Derrida were used. Main concepts are langue and parole, signifiant and signifie, syntagme and paradigme, denotation and connotation, synchronie and diachronie, identity of structure and differance etc. and methods are substituting these concepts to historical Shanghan theories from Zhongjing to Ming-Qing dynasty and comparisons of synchronie about their era. Essential qualities of Shanghan diseases are pathologic phenomena under the order of unification of nature and man formed through concrescence between individual human body and geo-climatico-socio-cultural environmental conditions, neither injuries by cold pathogen nor five types of exopathogenic febrile diseases. The former environmental elements can be inferred from general traits of desires and public pathological aspects of social members, and the latter personal factors from corresponding features to those pathogenic variables. In addition, the concepts of Shanghan disease are added successively up to now via Jin-Yuan's four great masters and Wenbing masters, and thus the new concepts of denotation became another connotation obtaining new signifiant. In this way, for the treatment of Shanghan diseases, new theories should be made for ranging prescription over the wenbing field; reflecting not only climatical variables but also each patient's physio-pathological features and sociocultural variables. Thereby an appropriate and reasonable therapeutical systems can be designed and can guide research direction hereafter.

Factors Influencing Nursing Students' Social Distancing for COVID-19 Prevention (간호대학생의 COVID-19 감염 예방을 위한 사회적 거리두기 영향요인)

  • Jo, Eun Bi;Hwang, Cho Rong;Yu, Jae Oak;Shin, Hyeon Jin;Kim, Yu Jin;Choi, A Ron;Lee, Hanna
    • Journal of East-West Nursing Research
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    • v.26 no.2
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    • pp.167-175
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    • 2020
  • Purpose: This study aims to understand the effect of attitudes toward COVID-19, subjective norms, and intentions toward social distancing as a preventative measure for COVID-19 in nursing university students, and to provide basic data for COVID-19 prevention. Methods: A cross-sectional study design was used in this study. The participants included 169 nursing students at a university in G city. Data were collected from 22 May 2020 to 1 June 2020. A self-report questionnaire was used. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression analyses with the IBM/SPSS 26.0 for Window Program. Results: Intention was the most influential factor on social distancing (β=.29, p=.002), followed by the number of breakfasts per week (β=.18, p=.005), school grade (β=-.16, p<.001), and smoking status (β=-.13, p=.046). These variables explained 35.0% of factors influencing social distancing (F=12.24, p<.001). Conclusion: The results of this study are meaningful and present a direction for nursing students and future medical personnel to effectively perform social distancing. It is necessary to educate nursing students so that they can practice proper health care habits and intentions for social distancing.

Sacral Insufficiency Fractures : How to Classify?

  • Bakker, Gesa;Hattingen, Joerg;Stuetzer, Hartmut;Isenberg, Joerg
    • Journal of Korean Neurosurgical Society
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    • v.61 no.2
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    • pp.258-266
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    • 2018
  • Objective : The diagnosis of insufficiency fractures of the sacrum in an elder population increases annually. Fractures show very different morphology. We aimed to classify sacral insufficiency fractures according to the position of cortical break and possible need for intervention. Methods : Between January 1, 2008 and December 31, 2014, all patients with a proven fracture of the sacrum following a low-energy or an even unnoticed trauma were prospectively registered : 117 females and 13 males. All patients had a computer tomography of the pelvic ring, two patients had a magnetic resonance imaging additionally : localization and involvement of the fracture lines into the sacroiliac joint, neural foramina or the spinal canal were identified. Results : Patients were aged between 46 and 98 years (mean, 79.8 years). Seventy-seven patients had an unilateral fracture of the sacral ala, 41 bilateral ala fractures and 12 patients showed a fracture of the sacral corpus : a total of 171 fractures were analyzed. The first group A included fractures of the sacral ala which were assessed to have no or less mechanical importance (n=53) : fractures with no cortical disruption ("bone bruise") (A1; n=2), cortical deformation of the anterior cortical bone (A2; n=4), and fracture of the anterolateral rim of ala (A3; n=47). Complete fractures of the sacral ala (B; n=106) : parallel to the sacroiliac joint (B1; n=63), into the sacroiliac joint (B2; n=19), and involvement of the sacral foramina respectively the spinal canal (B3; n=24). Central fractures involving the sacral corpus (C; n=12) : fracture limited to the corpus or finishing into one ala (C1; n=3), unidirectional including the neural foramina or the spinal canal or both (C2; n=2), and horizontal fractures of the corpus with bilateral sagittal completion (C3; n=8). Sixty-eight fractures proceeded into the sacroiliac joint, 34 fractures showed an injury of foramina or canal. Conclusion : The new classification allowes the differentiation of fractures of less mechanical importance and a risk assessment for possible polymethyl methacrylate leaks during sacroplasty in the direction of the neurological structures. In addition, identification of instable fractures in need for laminectomy and surgical stabilization is possible.

Present Status of Healthcare Strategy and its Application to Oral Health in D.P.R Korea (북한 보건의료전략의 분석과 치과 분야에서의 적용 현황 고찰)

  • Jung, Seoyeon;Joo, Woochan;Jo, Jaehyun;An, Kyeongsoo;Lee, Haewon;Choi, Seong-Ho;Jung, Hoi-In
    • The Journal of the Korean dental association
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    • v.58 no.9
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    • pp.536-545
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    • 2020
  • In preparing for the era of Korean reunification, it is essential to consider the integration of medical systems and human resources. While Korean dental practitioners are expanding their activities in various fields both domestically and internationally, there are many restrictions on the activities for improving the health of North Korean people due to political and historical reasons even nowadays. In addition, there is little is known about the current state of dental health in North Korea. We analyzed the reports published by the World Health Organization (WHO) and the Ministry of Public Health of North Korea prepared individually or in cooperation, and investigated the current status of the health care strategy applied to the dental field by conducting a full investigation of the 2018 『Rodong』newspaper. Based on the above, we tried to grasp the major health care strategies in North Korea and their application. Understanding the direction and status of North Korea's health care system would be an important cornerstone for international cooperation and practical activities to improve oral health care of North Koreans in the future. And there is a need that studies should be steadily conducted in various methods to overcome the heterogeneity of the two Koreas in the long-term perspective.

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A Study on the Tensor-Valued Median Filter Using the Modified Gradient Descent Method in DT-MRI (확산텐서자기공명영상에서 수정된 기울기강하법을 이용한 텐서 중간값 필터에 관한 연구)

  • Kim, Sung-Hee;Kwon, Ki-Woon;Park, In-Sung;Han, Bong-Soo;Kim, Dong-Youn
    • Journal of Biomedical Engineering Research
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    • v.28 no.6
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    • pp.817-824
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    • 2007
  • Tractography using Diffusion Tensor Magnetic Resonance Imaging (DT-MRI) is a method to determine the architecture of axonal fibers in the central nervous system by computing the direction of the principal eigenvector in the white matter of the brain. However, the fiber tracking methods suffer from the noise included in the diffusion tensor images that affects the determination of the principal eigenvector. As the fiber tracking progresses, the accumulated error creates a large deviation between the calculated fiber and the real fiber. This problem of the DT-MRI tractography is known mathematically as the ill-posed problem which means that tractography is very sensitive to perturbations by noise. To reduce the noise in DT-MRI measurements, a tensor-valued median filter which is reported to be denoising and structure-preserving in fiber tracking, is applied in the tractography. In this paper, we proposed the modified gradient descent method which converges fast and accurately to the optimal tensor-valued median filter by changing the step size. In addition, the performance of the modified gradient descent method is compared with others. We used the synthetic image which consists of 45 degree principal eigenvectors and the corticospinal tract. For the synthetic image, the proposed method achieved 4.66%, 16.66% and 15.08% less error than the conventional gradient descent method for error measures AE, AAE, AFA respectively. For the corticospinal tract, at iteration number ten the proposed method achieved 3.78%, 25.71 % and 11.54% less error than the conventional gradient descent method for error measures AE, AAE, AFA respectively.

Does the maxillary anterior ratio in Korean adults follow the Golden Proportion?

  • Jin, Ming-Xu;Hong, Min-Ho;Lee, Kee-Joon;Lee, Kyu-Bok
    • The Journal of Advanced Prosthodontics
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    • v.8 no.2
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    • pp.125-130
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    • 2016
  • PURPOSE. The purpose of this study was to determine the effect of changes in the horizontal plane angle on the mesiodistal width ratios of the maxillary anterior teeth during the acquisition of frontal view photographs, derive these ratios for Korean adults on the basis of the data obtained, and analyze them using the Golden Proportion as a reference. MATERIALS AND METHODS. In experiment I, 30 plaster casts were mounted on an articulator and positioned on the angle-measuring device with a center setting of $0^{\circ}$. The device was rotated to $10^{\circ}$ in $1^{\circ}$ increments in a counterclockwise direction. At each angle, photographs were obtained and analyzed. Experiment II was based on 60 patients who visited the Department of Prosthodontics at Kyungpook National University Dental Hospital from February 2012 to February 2015. The patients were divided into three groups [Male (M), Female (F), Total (M + F)]. Frontal views were obtained for all groups and analyzed. RESULTS. From $1^{\circ}$ to $10^{\circ}$, the relative mesiodistal width ratios for the maxillary anterior teeth showed no significant differences from those at $0^{\circ}$. In all three groups, the relative width ratio of the maxillary central incisor was smaller than that specified in the Golden Proportion; the opposite was true for the canine. CONCLUSION. Our results suggest that the mesiodistal width ratios of the maxillary anterior teeth do not follow the Golden Proportion in Korean adults, and that a change in the horizontal plane angle from $1^{\circ}$ to $10^{\circ}$ during frontal photography does not affect these ratios.

Interventions for anesthetic success in symptomatic irreversible pulpitis: A network meta-analysis of randomized controlled trials

  • Sivaramakrishnan, Gowri;Alsobaiei, Muneera;Sridharan, Kannan
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.6
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    • pp.323-341
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    • 2019
  • Background: Local anesthetics alone or in combination with adjuncts, such as oral medications, have routinely been used for pain control during endodontic treatment. The best clinical choice amongst the vast numbers of agents and techniques available for pain control for irreversible pulpitis is unclear. This network meta-analysis combined the available evidence on agents and techniques for pulpal anesthesia in the maxilla and mandible, in order to identify the best amongst these approaches statistically, as a basis for future clinical trials. Methods: Randomized trials in MEDLINE, DARE, and COCHRANE databases were screened based on inclusion criteria and data were extracted. Heterogeneity was assessed and odds ratios were used to estimate effects. Inconsistencies between direct and indirect pooled estimates were evaluated by H-statistics. The Grading of Recommendation, Assessment, Development, and Evaluation working group approach was used to assess evidence quality. Results: Sixty-two studies (nine studies in the maxilla and 53 studies in the mandible) were included in the meta-analysis. Increased mandibular pulpal anesthesia success was observed on premedication with aceclofenac + paracetamol or supplemental 4% articaine buccal infiltration or ibuprofen+paracetamol premedication, all the above mentioned with 2% lignocaine inferior alveolar nerve block (IANB). No significant difference was noted for any of the agents investigated in terms of the success rate of maxillary pulpal anesthesia. Conclusion: Direct and indirect comparisons indicated that some combinations of IANB with premedication and/or supplemental infiltration had a greater chance of producing successful mandibular pulpal anesthesia. No ideal technique for maxillary anesthesia emerged. Randomized clinical trials with increased sample size may be needed to provide more conclusive data. Our findings suggest that further high-quality studies are required in order to provide definitive direction to clinicians regarding the best agents and techniques to use for mandibular and maxillary anesthesia for irreversible pulpitis.